Visual Dermatology Clinic: Deer Tick

66 year old Male presented for a "skin tag" on his left posterior leg for 2-3 weeks. Patient denies pain but does report some tenderness when it brushes the sheets of his bed.Upon examination was these photos:

A 6mm punch bx was performed and the insect was sent for identification.The lab identified the tick as an Adult female deer tick (Ixodes scapularis). The patient then opted to pay $110 for 3 Pathogen Tick Panel which included:

Negative for Borrelia burgdorferi (the causative agent of Lyme Disease).